Optimal remifentanil dosage for providing excellent

Anaesthesia · Jul 2009

Randomized Controlled Trial

Optimal remifentanil dosage for providing excellent intubating conditions when co-administered with a single standard dose of propofol.

This dose-response study aimed to determine the dose of remifentanil combined with propofol 2.5 mg.kg(-1) which provided excellent intubation conditions in 95% of patients. Ninety premedicated female ASA 1 and 2 patients were randomly allocated to five remifentanil dose groups (1, 2, 3, 4 or 5 microg.kg(-1)). Induction of anaesthesia was performed with a blinded dose of remifentanil infused over 60 s simultaneously co-administered with propofol 2.5 mg.kg(-1) infused over 45 s. ⋯ Intubating conditions were assessed with the Copenhagen score. A probit analysis was performed to calculate the intubating efficient doses (IED) of remifentanil in 95% of patients (IED(95)). Our data revealed that the IED(95) of remifentanil was 4.0 (95% CI: 3.4-5.6) microg.kg(-1), which was associated with a maximum decrease in heart rate and mean arterial pressure of < 30%, a finding which also applied to the other groups.

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- L Bouvet, A Stoian, T Rimmelé, B Allaouchiche, D Chassard, and E Boselli.
- Claude Bernard University, University of Lyon, Lyon, France. lionel.bouvet@chu-lyon.fr
- Anaesthesia. 2009 Jul 1;64(7):719-26.
AbstractThis dose-response study aimed to determine the dose of remifentanil combined with propofol 2.5 mg.kg(-1) which provided excellent intubation conditions in 95% of patients. Ninety premedicated female ASA 1 and 2 patients were randomly allocated to five remifentanil dose groups (1, 2, 3, 4 or 5 microg.kg(-1)). Induction of anaesthesia was performed with a blinded dose of remifentanil infused over 60 s simultaneously co-administered with propofol 2.5 mg.kg(-1) infused over 45 s. Tracheal intubation was attempted 150 s after the beginning of induction. Intubating conditions were assessed with the Copenhagen score. A probit analysis was performed to calculate the intubating efficient doses (IED) of remifentanil in 95% of patients (IED(95)). Our data revealed that the IED(95) of remifentanil was 4.0 (95% CI: 3.4-5.6) microg.kg(-1), which was associated with a maximum decrease in heart rate and mean arterial pressure of < 30%, a finding which also applied to the other groups.

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Optimal remifentanil dosage for providing excellent intubating conditions when co-administered with a single standard dose of propofol.

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